Effect of continuous esketamine infusion on brain white matter microstructure in patients with major depression: A diffusion tensor imaging study.
Journal of affective disorders March 1, 2025 Xiang Liu, Zhipeng Wei, Lifeng Li et al. 12 citations
People with major depressive disorder show widespread damage to the brain's white matter, particularly in fibers connecting different regions. A two-week treatment with intravenous esketamine (0.25 mg/kg) effectively reduced depression, anxiety, and suicidal thoughts and improved cognitive function in 20 patients compared to 20 healthy controls. However, brain scans revealed that the damaged white matter did not recover during this short treatment period. The degree of damage in certain projection fibers was linked to the severity of anxiety and suicidal ideation. The study lacked a placebo control and many patients also took sertraline, making it difficult to isolate esketamine's specific effects on the brain.